JoVE - Journal of Visualized Experiments
JoVE Visualize
Contact Us

Multifactorial clinical analysis of factors affecting necrosis of nasal septal mucosal flap after salvage surgery for recurrent nasopharyngeal carcinoma

  • 0Department of Head and neck surgery, Clinical Oncology School of Fujian Medical University, Fujian Cancer Hospital (Fujian Branch of Fudan University Shanghai Cancer Center), Fuzhou, 350014, Fujian Province, China.
Scientific Reports +

|

November 26, 2024

|

November 26, 2024

View abstract on PubMed

Summary

This summary is machine-generated.

Second-course radiotherapy, advanced T stage, and longer recurrence times increase the risk of nasal septal mucosal flap (NSF) necrosis after nasopharyngeal carcinoma (NPC) salvage surgery. Shorter packing times also elevate this risk.

Area Of Science

  • Otolaryngology
  • Surgical Oncology
  • Head and Neck Cancer Research

Background

  • Recurrent nasopharyngeal carcinoma (NPC) often requires salvage surgery.
  • Nasal septal mucosal flap (NSF) reconstruction is common in these procedures.
  • Understanding risk factors for NSF necrosis is crucial for improving outcomes.

Purpose Of The Study

  • To identify independent risk factors for nasal septal mucosal flap (NSF) necrosis following endoscopic salvage surgery for recurrent nasopharyngeal carcinoma (NPC).

Main Methods

  • Retrospective analysis of patients undergoing endoscopic salvage surgery for recurrent NPC with NSF repair.
  • Logistic regression analysis to determine independent risk factors.
  • Factors evaluated included prior radiotherapy, recurrence T stage, recurrence interval, and postoperative nasal packing duration.

Main Results

  • Second-course radiotherapy (OR 8.338), advanced T stage recurrence, and longer recurrence times were significant risk factors for NSF necrosis.
  • Postoperative nasal packing for less than 5 days was associated with a higher risk of flap necrosis compared to packing for 5 days or more.
  • A predictive model showed good predictive capability for NSF necrosis.

Conclusions

  • Second-course radiotherapy history, advanced recurrence T stage, longer recurrence time, and shorter postoperative packing duration are independent risk factors for NSF necrosis after NPC salvage surgery.
  • These findings can inform surgical planning and postoperative care to mitigate flap necrosis.
  • Optimizing nasal packing duration may reduce the incidence of NSF necrosis.

Keywords: